Neurogenic shock

Neurogenic shock is a distributive form of shock producing low blood pressure, often together with a slowed heart rate, caused by disruption of the autonomic nervous system's pathways. It most often follows damage to the central nervous system, particularly spinal cord injuries above the sixth thoracic vertebra or severe traumatic brain injuries, when trauma suddenly removes sympathetic nervous system stimulation, causing blood vessels to dilate and blood to pool in the extremities instead of circulating normally. Patients typically show an abrupt drop in blood pressure along with warm, flushed skin from vasodilation, while the heart rate stays abnormally slow because the body cannot mount its usual stress response, alongside dizziness, anxiety and labored breathing, with high cervical injuries risking respiratory compromise or arrest. It is a medical emergency that can lead to organ dysfunction and death without prompt recognition and treatment, occurring in roughly half of spinal cord injury patients within the first 24 hours and typically persisting one to three weeks.